INDICATIONS FOR EXCHANGE TRANSFUSION BASED UPON THE ROLE OF ALBUMIN IN THE TREATMENT OF HEMOLYTIC DISEASE OF THE NEWBORN

PEDIATRICS ◽  
1964 ◽  
Vol 33 (5) ◽  
pp. 749-757
Author(s):  
William J. Waters ◽  
Eva Porter
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Binding Capacity ◽  
Hemoglobin Concentration ◽  
Hemolytic Disease ◽  
History Of ◽  
Unnecessary Procedures ◽  
Previously Treated ◽  
Reserve Albumin

Maternal titer, history of previously treated sibling, positive Coombs, prematurity, cord serum bilirubin, and hemoglobin concentration do not by themselves indicate the need for immediate exchange transfusion in an infant who shows no signs of disease. The measurement of the reserve albumin binding capacity is a useful aid in determining the need for exchange transfusion in preventing bilirubin encephalopathy. A delay in treatment of infants who have an adequate reserve binding capacity does not increase the need for re-exchange and avoids unnecessary procedures. The rate of re-exchange among infants receiving added albumin and managed according to the criteria outlined was lower than in the conventionally treated series.

CURRENT STATUS OF USE OF EXCHANGE TRANSFUSION IN NEWBORN INFANTS

PEDIATRICS ◽  
1964 ◽  
Vol 33 (5) ◽  
pp. 763-767
Author(s):  
R. James Mckay
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Binding Capacity ◽  
Newborn Infants ◽  
Clinical Signs ◽  
Serum Bilirubin Level ◽  
Current Status ◽  
Hemolytic Disease ◽  
Blood Ph ◽  
Absolute Indication

The only absolute indication for exchange transfusion is the appearance of clinical signs of early kernicterus whatever the level of serum bilirubin. The decision as to whether or not to perform an exchange transfusion should be made on an individual basis and should take into consideration factors other than the serum bilirubin level. Such factors include the experience of the operator, the degree of illness of the infant, presence or absence of hemolytic disease, asphyxia, cyanosis, low blood pH, hypoglycemia, hypoproteinemia, and degree of immaturity. The PSP binding capacity of the patient's serum may also turn out to be a valuable guide or even an absolute indication after experience with it has accumulated.

scholarly journals Severe hemolytic disease of the premature newborn due to RH1 incompatibility: a case report

2016 ◽  
Vol 89 (4) ◽  
pp. 565-568 ◽  
Author(s):  
Jean Uwingabiye ◽  
Hafid Zahid ◽  
Fayçal Labrini ◽  
Abdelhak El Khazraji ◽  
Anass Yahyaoui ◽  
...  
Keyword(s):  
Blood Group ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
Hemolytic Disease ◽  
Close Collaboration ◽  
Haemolytic Disease ◽  
Total Serum Bilirubin Level ◽  
Antiglobulin Test ◽  
History Of

We report a case of dramatic outcome of severe haemolytic disease in a newborn due to RH1 incompatibility. A newborn with A RH1 blood group was admitted in the Mohammed V Military Teaching Hospital for the problem of hydrops fetalis associated with RH1 incompatibility. The blood group of his mother, aged 31, was AB RH1-negative and that of his 37 year old father was A RH1.The mother had a history of 4 term deliveries, 3 abortions, and 1 living child. There was no prevention by anti-D immunoglobulin postpartum. The mother‘s irregular agglutinin test was positive and the pregnancy was poorly monitored. The laboratory tests of the newborn showed a high total serum bilirubin level (30 mg/L) and macrocytic regenerative anemia (Hemoglobin=4 g/dL, mean corpuscular volume = 183 fL, reticulocytes count =176600/m3). The blood smear showed 1256 erythroblasts per 100 leukocytes, Howell–Jolly bodies and many macrocytes. The direct antiglobulin test was positive. He was transfused with red blood cell concentrates and treated with conventional phototherapy. The evolution was unfavourable; he died three days after the death of his mother. The monitoring of these high-risk pregnancies requires specialized centers and a close collaboration between the gynaecologist and the blood transfusion specialist to strengthen the prevention, as well as clinico-biological monitoring in patients with a history of RH1 fetomaternal alloimunization.

scholarly journals Phenobarbital and Phototherapy Combination Enhances Decline of Total Serum Bilirubin and May Decrease the Need for Blood Exchange Transfusion in Newborns with Isoimmune Hemolytic Disease

2015 ◽  
Vol 9 ◽  
pp. CMPed.S24909 ◽  
Author(s):  
Mahmoud A. F. Kaabneh ◽  
Ghassan S. A. Salama ◽  
Ayoub G. A. Shakkoury ◽  
Ibrahim M. H. Al-Abdallah ◽  
Afrah Alshamari ◽  
...  
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Hemolytic Disease ◽  
Blood Exchange ◽  
Blood Exchange Transfusion ◽  
Group 2 ◽  
Group 1

Objective The objective of this study was to evaluate the effect of phenobarbital and phototherapy combination on the total serum bilirubin of the newborn infants with isoimmune hemolytic disease (IHD) and its impact on blood exchange transfusion rates. Patients and Method This single-blinded, prospective, randomized, controlled trial was conducted between March 2013 and December 2014 at the pediatric ward of two Military Hospitals in Jordan. A total of 200 full-term neonates with IHD were divided randomly into two groups: (1) the phenobarbital plus phototherapy group ( n = 103), and (2) the phototherapy-only group ( n = 97). Infants in group 1 received an oral dose of 2.5 mg/kg phenobarbital every 12 hours for 3 days in addition to phototherapy. The total serum bilirubin was observed. Results Of the total 200 included newborn infants, 186 infants completed the study: 97 infants were included in group 1 and 89 infants in group 2. The difference between the mean total serum bilirubin levels at 24, 48, and 72 hours after starting the trial was clinically and statistically significant at P < 0.05. The differences between the two groups were also statistically significant at P < 0.05. Of the total 186 who completed the study, only 22 underwent blood exchange transfusion [7 from group 1, and 15 from group 2 ( P = 0.0478)]. Conclusion In a limited-resources setting, phenobarbital in combination with phototherapy may be helpful to newborn infants with IHD, as it results in a faster decline in total serum bilirubin, thus decreasing the need for blood exchange transfusion than phototherapy alone.

ABO Hemolytic Disease: A Comparative Study of Clinical Severity and Delayed Anemia

PEDIATRICS ◽  
1978 ◽  
Vol 62 (3) ◽  
pp. 365-369 ◽  
Author(s):  
William P. Kanto ◽  
Brenda Marino ◽  
Anita S. Godwin ◽  
Chantrapa Bunyapen
Keyword(s):  
Exchange Transfusion ◽  
Reticulocyte Count ◽  
Hemoglobin Concentration ◽  
Clinical Severity ◽  
Hemolytic Disease ◽  
Bilirubin Concentration ◽  
Clinical Difference ◽  
Significant Difference ◽  
Abo Hemolytic Disease ◽  
Hemoglobin Measurement

The hospital and clinic records of 230 neonates with ABO hemolytic disease (HD) were reviewed. There was no significant difference in clinical severity between AO-HD and BO-HD as measured by (1) number of neonates with hyperbilinibinemia and/ or those requiring exchange transfusion; (2) hemoglobin concentration; (3) reticulocyte count; (4) bilirubin concentration; and (5) incidence of anemia after discharge from the hospital. There was no difference in the hemoglobin concentrations measured at between four and eight weeks of age in 39 control infants and infants with either AO-HD or BO-HD who did not require an exchange transfusion. Our data do not indicate a clinical difference in the severity of AO-HD and BO-HD. Infants with ABO-HD who do not require exchange transfusion and/or phototherapy and whose hemoglobin concentration at discharge is &gt; 15 gm/dl do not need a hemoglobin measurement before 6 weeks of age.

Role of Short Duration Double Phototherapy in The Treatment of Unconjugated Hyperbilirubinemia

2021 ◽  
Vol 17 (3) ◽  
pp. 251-254
Author(s):  
Benish Fatima ◽  
Syed Taqi Hassan Zaidi ◽  
Ameena Saba
Keyword(s):  
Skin Reaction ◽  
Short Duration ◽  
Serum Bilirubin ◽  
P Value ◽  
Unconjugated Hyperbilirubinemia ◽  
History Of ◽  
Series Study ◽  
Neonatal Ward ◽  
Key Words Hyperbilirubinemia

Objective: To determine the role of short duration double phototherapy in the treatment of unconjugated hyperbilirubinemia. Materials and Methods: This prospective cases series study was conducted at pediatric department of CMH hospital at Malir Karachi. All the neonates diagnosed with unconjugated hyperbilirubinemia admitted to the neonatal ward were included. All the cases underwent short duration double phototherapy. Babies were observed for side-effects of phototherapy, like skin reaction and dehydration. Serum bilirubin was checked by bilirubinometre after 6 hourly of the treatment. Al the data was collected via study proforma. Data was analyzed by using SPSS version 20 Results: Total 74 neonates were studied, most of the neonates presented within 48-72 hours after birth. Majority of the term babies as 59.5% had history of 37-40 weeks of gestation and 28.4% had gestational age history >40 weeks. Out of all, males’ babies were 58.1% and female babies were 41.9%. Neonatal bilirubin level was significantly decreased from bassline 18.35+0.97 after 6 hours of double phototherapy as 14.66+1.18 with mean difference of 3.68+1.37 (p-value 0.001). Conclusion: Short duration double phototherapy found to be the effective, reliable and safe for skin reaction in the treatment of unconjugated hyperbilirubinemia. Key words: Hyperbilirubinemia, double phototherapy, six hours  

scholarly journals Depressive disorders – the nurse’s role in the education of the patient and his family

2015 ◽  
Vol 9 (1) ◽  
pp. 24-27
Author(s):  
Ałła Woźniak
Keyword(s):  
Mental State ◽  
Depressive Disorders ◽  
Negative Impact ◽  
Special Treatment ◽  
Comprehensive Treatment ◽  
Treatment Team ◽  
Psychomotor Slowing ◽  
History Of ◽  
Previously Treated

Background: Depression is a chronic, relapsing disease. Disorder is not only physical and mental state of man, but also its function in society. Patients and their families often have a lack of knowledge about the disease, which has a negative impact on the course and duration of the patient’s disease. Treating depression is a long-term process, requiring special treatment of the patient. Comprehensive treatment of depression requires the cooperation of all members of the treatment team, as the participation of the patient and his family.Aim of the study: The aim of the study is to present the role of education of the patient and his family to restore it to act independently in the environment, and the role of nurses in psycho-education of the patient and his family.Material and methods: Patient information was collected by interview with the patient and his family. Observation of the patient was performed for the entire period of hospitalization. An analysis of the documentation of the medical history of the patient in the ward.Case: The subject of description is 58-year-old patient brought to the Provincial Team Specialist Neuropsychiatric in Opole by Team Rescue after a suicide attempt. The patient was admitted to the department for their own consent with the diagnosis; recurrent depressive disorders;. The patient was previously treated in the local hospital in 2010. In the first day of the patient in reduced mood, psychomotor slowing in confirming thoughts suicidal. Used pharmacological treatment, individual and group psychotherapy. The patient participated in various forms of occupational therapy. As a result of the implemented measures nursing patient fully accepted his illness and acquired knowledge and skills on how to deal with it in order to maintain mental balance.Conclusions: Used in patient therapy including psychoeducation comprehensive nurse brought the expected results. Mental state improved. The patient was discharged from the hospital with instructions.

The single supratentorial lesion

1980 ◽  
Vol 53 (3) ◽  
pp. 364-368 ◽  
Author(s):  
Rand M. Voorhies ◽  
Narayan Sundaresan ◽  
H. Tzvi Thaler
Keyword(s):  
Metastatic Lesion ◽  
Primary Site ◽  
Intravenous Pyelogram ◽  
Content Type ◽  
X Ray ◽  
Preoperative Diagnostic ◽  
History Of ◽  
Chest X Ray ◽  
Previously Treated

✓ The role of preoperative diagnostic tests was evaluated in 210 adult patients with single supratentorial lesions demonstrated by computerized tomography. At craniotomy, 59.5% of these patients proved to have primary brain tumors, 36.2% had metastatic tumors, and 4.3% had non-neoplastic lesions. In 23 (11%) of these patients, a single brain metastasis was the first manifestation of a systemic cancer. The primary site of cancer was identified in 14 patients (10 in the lung, three in the kidney, and one in the colon), and in nine patients the primary site could not be established. Using simple conditional probability theory, we established that the probability of a metastatic lesion in patients without a history of previously treated cancer is about 7%, if their chest x-ray film and intravenous pyelogram (IVP) are negative. Extensive preoperative testing to try to establish a primary site is unrewarding if the chest x-ray film and IVP are negative, since these are the only sites likely to be identified in these patients. In patients with a history of previously treated cancer, these tests are justified because they have prognostic value in determining treatment.

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